Antiretroviral Treatment Costs in Mexico Sergio Bautista, Tania Dmytraczenko, Gilbert Kombe and Stefano Bertozzi WHO/UNAIDS Workshop on Strategic Information for Anti-Retroviral Therapy Programmes 30 June to 2 July, 2003 Assessment of programme outcomes (economic) Purpose of the Study To document—using a consistent methodology—the Mexican experience in HIV/AIDS treatment in 3 health subsystems – Ministry of Health (SSA) – Mexican Social Security Institutes (IMSS/ISSSTE) – National Institutes of Health (INS) Presentation prepared by INSP, 30 June 2003 Specific Objectives of the Study Identify patterns of HIV/AIDS care and treatment and related costs by type of therapy received – ARV triple therapy or not To estimate the annual care costs per patient by •Subsystems SSA, IMSS/ISSSTE, INS •Care setting Inpatient, outpatient Presentation prepared by INSP, 30 June 2003 •Level of care Specialized clinics, secondary and tertiary hospitals •Disease stage CDC classification CD4 Study Approach: Site selection 11 health facilities were selected – SSA sites (5) – IMSS/ISSSTE sites (4) – INS sites (2) Level of Care Geographic Location – Mexico City (6) – Highly specialized tertiary care facilities (3) – Guadalajara (2) – Secondary care facilities (7) – Cuernavaca (2) – Specialized HIV clinic (1) Presentation prepared by INSP, 30 June 2003 Study Approach: Sample size and eligibility Convenience sample to reflect clinical and treatment criteria of interest: – – – – ARV recipients (75%) Not on ARVs (15%) Deceased (10%) 1062 patients randomly selected, with sample stratification Patients eligibility criteria – 18 years or older at first consultation – Diagnosed with HIV and confirmed by Western, Elisa or laboratory culture, or symptomatic AIDS – Documented visit at a study site between 1/1/2000- 12/31/2001 Presentation prepared by INSP, 30 June 2003 Data Collection Instruments Utilization (patient chart review) – Socio-demographic characteristics – Clinical events including outpatient, inpatient, labs, drugs, surgical procedures and interventions Unit costs (facility questionnaire) – Existing unit cost data • Facility- or subsystem-specific – Micro-costing of AIDS-specific diagnostic tests and drugs – Recurrent costs (except for AIDS-specific tests) Presentation prepared by INSP, 30 June 2003 Data Collection Process 5 trained teams, each composed of an economist and a MD/nurse Data were captured retrospectively for a period of 3 years from the date of last consultation in the study period Accuracy and reliability of data collection was strengthened with real-time data entry in the field and error checking interface Presentation prepared by INSP, 30 June 2003 Characteristics of the Sample (n=1062) Education Primary or less Secondary+ Higher Mode of Transmission Unsafe injection Transfusion Occupational risk Sexual Sexual Preference Heterosexual, male Homosexual, male Bisexual, male Presentation prepared by INSP, 30 June 2003 SSA IMSS/ISSSTE INS (n=506) 30.0% 54.0% 16.0% (n=496) 1.2% 3.0% -95.8% (n=404) 40.3% 45.5% 14.1% (n=144) 9.0% 52.8% 38.2% (n=175) -5.7% -94.3% (n=127) 62.2% 29.9% 7.8% (n=87) 26.4% 55.2% 18.4% (n=69) -2.9% 1.5% 95.7% (n=44) 40.9% 43.2% 15.9% Key Finding #1: There has been a progressive and rapid uptake of HAART Distribution of Patients by Type of Therapy 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% (n = 49) (n = 138) (n = 326) (n = 567) (n = 496) Mono Double Triple 1997 1998 Presentation prepared by INSP, 30 June 2003 1999 2000 2001 Key finding #2: Patients start treatment in advanced stages, improvement is gradual Distribution of CD4 Count .003 year –1 (n = 319) year 1 (n = 712) year 3 (n = 140) .002 .001 0 0 500 Presentation prepared by INSP, 30 June 2003 1000 1500 2000 Key Finding #3: Total costs are substantially higher under HAART US$ Average Annual per Patient Cost of Treatment 4500 4000 3500 3000 2500 2000 1500 1000 500 0 Hospitalization Outpatient visits Lab tests OI drugs + procedures ARV drugs -3 -2 -1 (n = 45) (n = 153) (n = 612) 1 2 (n = 792) (n = 459) (n = 201) Years pre- and post-HAART Presentation prepared by INSP, 30 June 2003 3 Key Finding #4: Lab tests and Outpatient visits are the largest contributors to treatment costs, excluding ARVs US$ Average Annual per Patient Cost of Treatment, Excl. ARVs 900 800 700 600 500 400 300 200 100 0 Hospitalization Outpatient visits OI drug + procedures Lab tests -3 -2 -1 (n = 45) (n = 153) (n = 612) 1 2 (n = 792) (n = 459) (n = 201) Years pre- and post-HAART Presentation prepared by INSP, 30 June 2003 3 Key Finding #5: Treatment costs are higher for patients in advanced stages of illness Avg Annual per Patient Cost of Treatment Excl. ARVs, by CD4 count CD4 Range 0-199 Outpatient Hospital Lab OI drugs+ visits days tests procedures Total 190 104 759 91 1144 205 36 603 30 874 279 23 566 21 888 271 8 496 61 836 (n = 1016) 200-349 (n = 484) 350-499 (n = 270) >500 (n = 306) Presentation prepared by INSP, 30 June 2003 Summary Our findings are consistent with studies done in other countries – ARV comprises >75% of total treatment costs – Outpatient and monitoring costs increase as patients start triple therapy Unlike Sub-Saharan African countries, hospitalization is not a big factor in Mexico Costs associated with late initiation of treatment and during last year of life Presentation prepared by INSP, 30 June 2003 Policy Recommendations I Governments should be realistic about resource requirements of starting and scaling-up ARV treatment – Lab capacity – Human resource training Countries should be prepared for the shift in care and treatment patterns of patients on HAART especially from inpatient to outpatient Clinicians should clearly understand when to initiate and how to monitor patients on therapy Presentation prepared by INSP, 30 June 2003 Policy Recommendations II Estimating total cost of ARV treatment can significantly help countries plan for scaling-up – Negotiating drug prices Medium to long-term prospective is needed for a full evaluation of program costs Presentation prepared by INSP, 30 June 2003 Presentation prepared by INSP, 30 June 2003